Citation
J Haem Pract 2014; 1(3):J Haem Pract 2014; 1(3): 3-6. doi: 10.17225/jhp00027

Authors: Franchesca Fong, Janet Davies, Janice Fearne, John Pasi

Franchesca Fong
Paediatric Dental Department, Royal London Dental Hospital, New Road, London, UK. Email: franchesca.fong@nhs.net

Janet Davies
Paediatric Dental Department, Barts Health NHS Trust, W Smithfield, London EC1A 7BE, UK.

Janice Fearne
Paediatric Dental Department, Barts Health NHS Trust, W Smithfield, London EC1A 7BE, UK.

John Pasi
The Royal London Haemophilia Centre, Bart Health NHS Trust, London E1 1BB, UK.

Abstract

The Royal London Hospital is a major referral centre for children with inherited bleeding disorders (IBD). Dental caries and periodontal disease can be prevented, which is especially important in these children to avoid invasive treatment. For this reason a care pathway has been established, focusing on appropriate prevention advice and treatment
A Paediatric Dental Specialist attends the monthly Paediatric Haematology clinics. Children are screened for untreated dental decay and preventive dental advice is given verbally along with a patient information leaflet. At the clinic, a letter is sent out to the patient’s general dental practitioner (GDP). Non-registered patients are directed to NHS Choices website to find a local NHS GDP. Liaison of GDPs with both haematology and hospital paediatric dental services is actively encouraged to support the provision of dental care within the primary care setting, particularly routine preventive care. Depending on the severity of the bleeding diathesis and the degree of invasive dental treatment required, the GDP may undertake simple treatment or, in more complex cases, may arrange a referral to the Royal London Dental Hospital.
A consultation process takes place between paediatric dentist, paediatric haematologist and specialist nurse to determine the most appropriate haematological cover for each patient. This will depend on the severity of the bleeding disorder, the complexity of dental treatment and the need for local anaesthesia. The date of the dental visits and the haemostatic cover are requested via the electronic patient record so that it is accessible to all clinicians involved in their care without the need to retrieve their paper notes.
This pathway encourages active involvement of the patients’ GDP and allows the patient to be treated as safely as possible in a timely manner. The care pathway has helped to formalise dental treatment for children with IBD and to improve every health care professional’s understanding of their role in this care.

Sample

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References

  1. Kalsi H, Nanayakkara L, Pasi KJ, Bowles L, Hart P. Access to primary dental care for patients with inherited bleeding disorders. Haemophilia 2012; 18(4): 510-515
  2. Tower Hamlets Council. 2011 Census Results: Headline Analysis. Population growth in Tower Hamlets, UK; July 2012. http://www.towerhamlets.gov.uk/idoc.ashx?docid=3e6f8654-7214-4882-b548-dd544d51ad83&version=-1
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  4. Department of Health & The British Association for the Study of Community Dentistry. Delivering Better Oral Health: An evidence-based toolkit for prevention (Second Edition), GN2014126. London; 2014.

The Journal of Haemophilia Practice is published by Haemnet.

Haemnet is a registered charity that brings together and gives a voice to haemophilia nurses, physiotherapists and allied health care professionals, providing forums for collaborative research, educational activities and support.